A study on management of congenital clubfoot by Ponsetti technique in a rural medical college in India

Wazir Fahad Jan, Alamgir Jahan, Mohd Yahya Dar, Firdous Ahmad Bangroo

Abstract

Background: Congenital clubfoot also known as CTEV (congenital talipus equinovarus) is a common and debilitating congenital musculoskeletal anamoly affecting the children across the world with a slight preponderence in third world countries. The Ponseti technique of casting has now become the mainstay of treatment of this condition. This method is especially effective in rural and underdeveloped areas with limited health care facilities. The purpose of this study was to evaluate the effectiveness of the Ponsetti technique in the correction of this deformity, thorough the assessment of modified Pirani score.

Methods: This was a prospective observational study conducted on 75 patients of either sex with 100 feet, with an average age of 3.6 months presenting to the Orthopaedic OPD of SHKM Government Medical College Hospital, Nalhar, Nuh, Haryana between September 2015 and September 2017, with a diagnosis of congenital clubfoot. All the patients were treated with Ponsetti technique and the results were analysed through the assessment of modified Pirani score. The patients were followed up for a peroid of 1 year after attainment of correction.

Results: Majority of the patients obtained full correction with this method. The mean value of the modified Pirani score improved from the pre-treatment value of 5.30 to 0.36 at the final follow up. The average number of casts required for full correction was 7.32.

Conclusions: Thus results of our study demonstrate that the Ponsetti method is a safe and effective method of treatment for congenital clubfoot, especially in rural and underdeveloped regions.